Provider Demographics
NPI:1538593033
Name:ZILER, GRACE E
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:ZILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W MERCER ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:MO
Mailing Address - Zip Code:64755-9346
Mailing Address - Country:US
Mailing Address - Phone:417-394-2416
Mailing Address - Fax:417-394-2394
Practice Address - Street 1:201 W MERCER ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:MO
Practice Address - Zip Code:64755-9346
Practice Address - Country:US
Practice Address - Phone:417-394-2416
Practice Address - Fax:417-394-2394
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist